Pivot point arm for robotic system used to perform a surgical procedure

ABSTRACT

A pivot port that can provide a pivot point for a surgical instrument. The pivot port may be held in a stationary position by a support arm assembly that is attached to a table. The pivot port may include either an adapter or a ball joint that can support the surgical instrument. The pivot port allows the instrument to pivot relative to a patient.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a continuation of application Ser. No. 10/411,651,filed Apr. 10, 2003, which is a divisional of application Ser. No.09/847,736 filed May 1, 2001, now abandoned.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a pivot arm that can support a surgicalinstrument during a medical procedure.

2. Background Information

There have been developed surgical robots that assist surgeons inperforming medical procedures. By way of example, the assignee of thepresent invention, Computer Motion, Inc. of Goleta, Calif. sells amedical robotic arm under the trademark AESOP and a medical roboticsystem under the trademark ZEUS. The AESOP product includes a roboticarm that can be controlled through a foot pedal or voice commands fromthe surgeon. The AESOP arm is typically used to move an endoscope thatis inserted into a patient during a laparoscopic procedure. The ZEUSsystem includes multiple robotic arms that can control surgicalinstrument used to perform minimally invasive procedures. The ZEUSrobotic arms are controlled by handles that are manipulated by thesurgeon.

Coronary artery bypass graft (CABG) procedures can be performedminimally invasively using the ZEUS and AESOP products. The surgicalinstruments and endoscope are inserted through small incisions createdin the chest of the patient. The robotic arms include both active andpassive joints that move the instruments and endoscope aboutcorresponding pivot points. The pivot points are created by theincisions formed in the patient.

Some surgeons are uncomfortable performing minimally invasive CABGprocedures and will only perform the procedure with an opened chestcavity. There may still be a desire to utilize robotic arms to controlthe instruments even during an open chest procedure. For example, theZEUS system will filter the natural hand tremor of the surgeon.

There are no incisions or corresponding pivot points in an open chestprocedure. Unfortunately, the ZEUS and AESOP systems will not functionproperly without the pivot points created by the incisions. It istherefore desirable to create a pivot point for the robotic arms tofunction during a non-minimally invasive procedure.

Computer motion has provided a support arm that could support aninstrument during a non-minimally invasive procedure. The instrumentcould be inserted through a diaphragm located at the distal end of thearm. The diaphragm provided some flexibility to pivot the instrument butnot enough to allow sufficient movement by a robotic arm to perform mostmedical procedures.

BRIEF SUMMARY OF THE INVENTION

One embodiment of the present invention includes a pivot port that hasan adapter coupled to a pivot arm by a joint. Another embodimentincludes a ball joint that is coupled to a pivot arm.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an illustration of an embodiment of a medical system of thepresent invention;

FIG. 2 is a perspective view of a pivot port of the medical system;

FIG. 3 is a perspective view of an alternate embodiment of the pivotport.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

In general the present invention includes a pivot port that can providea pivot point for a surgical instrument moved by a robotic arm. Thepivot port may be held in a stationary position by a support armassembly that is attached to a table. The pivot port may include eitheran adapter or a ball joint that can support the surgical instrument. Thepivot port allows the instrument to pivot relative to a patient. Thepivot arm allows the robotically controlled surgical instrument to beused in a non-minimally invasive procedure such as an open chestcoronary artery bypass graft (CABG) procedure. Although use of the pivotarm in open chest CABG procedures is described, it is to be understoodthat the pivot arm can be used in other surgical procedures includingminimally invasive procedures. For example, the pivot arm can be used tohold an instrument for a minimally invasive CABG procedure.Additionally, the pivot arm can hold instruments that are notrobotically controlled.

Referring to the drawings more particularly by reference numbers, FIG. 1shows an embodiment of a medical system 10 of the present invention. Thesystem 10 may include a pivot port 12 that is held in a stationaryposition by a support arm assembly 14. The support arm assembly 14 maybe attached to a surgical table (not shown).

A surgical instrument 16 can be coupled to the pivot port 12. Thesurgical instrument 16 can be coupled to a robotic arm 18. The pivotport 12 is constructed so that the instrument 16 can pivot relative tothe arm 12 with a sufficient range of motion so that medical procedurescan be performed with the robotic arm 18.

The robotic arm 18 may include a linear actuator 20, a first rotaryactuator 22 and a second rotary actuator 24 that are controlled by acomputer (not shown) to move the surgical instrument 16. The robotic arm18 may also have an end effector (not shown) to spin and/or actuate theinstrument 16. The arm 18 may also have passive joints (not shown) thatallow the instrument 16 to pivot about the pivot port 12. The roboticarm 18 may be a product sold by Computer Motion, Inc. of Goleta, Calif.under the trademark AESOP or a Computer Motion product sold under thetrademark ZEUS, which are hereby incorporated by reference.

FIG. 2 shows an embodiment of the pivot port 12. The pivot port 12includes a first link 26 that is configured as a single connecting piecehaving pivotal ends, wherein a proximal end of the first link 26 is bentat an approximately 45 degree angle relative to a middle segment of thefirst link 26 and a distal end of the first link 26 is bent at anapproximately 135 degree angle relative to the middle segment of thefirst link 26. The proximal end of the first link 26 is directlyconnected to a pivot arm 28 by a first joint 30 that defines a firstaxis of rotation which is approximately coincident with a longitudinalaxis of the pivot arm 28. The distal end of the first link 26 isdirectly connected to only one outer side of a ring 32 by a second joint34 that defines a second axis of rotation which is approximatelyorthogonal to the first axis of rotation and which is approximatelycoincident with a diameter of the ring 32.

The pivot port 12 may include an adapter 36 that can be coupled to thering 32. The surgical instrument 16 can extend through an aperture 38 ofthe adapter 36. The aperture 38 should have a diameter that allows theinstrument 16 to spin and translate relative to the pivot port 12. Thefirst 30 and second 34 joints allow the ring 32 and correspondinginstrument to pivot about the arm 28 to provide yaw and pitch rotation.

The adapter 36 may have an outer annular flange 40 that rests on aninner annular lip 42 of the ring 32. The adapter 36 may be constructedto be readily attached and detached from the ring 32. This allowsadapters having different aperture diameters to be inserted into thepivot port 10 to accommodate different instrument sizes.

FIG. 3 shows an alternate embodiment of a pivot port 43 that includes aball joint 44 that can pivot relative to a ring 45. The ring 45 isattached to a pivot arm 46. The ball joint 44 may have a plurality ofapertures 48 that can receive a surgical instrument 16. The ball joint42 allows the instrument 16 to pivot relative to the arm 46. Opposingpairs of apertures 48 can be constructed to have different diameters toreceive instruments of different sizes. The ball joint 44 thus providesa joint that can accommodate different instrument sizes without havingto replace the joint as may be required in the embodiment shown in FIG.2.

Referring again to FIG. 1, support arm assembly 14 includes a supportarm 50 that is coupled to a table mount 52. The table mount 52 isadapted to be secured to a surgical table (not shown). The support armassembly 14 further includes an end effector 54 that is coupled to thearm 50. The end effector 54 is adapted to hold the pivot arm 28 or 46 ofthe pivot port 12, or 43, respectively.

The arm 50 may include a first linkage 56 that is coupled to the tablemount 52 and a second linkage 58 coupled to the first linkage 56. Thearm 50 may further have a third linkage 60 coupled to the second linkage58.

The first linkage 56 may extend through a clearance hole (not shown) ina base 62 of the table mount 52. The table mount 52 may have an armclamp 64 that can be rotated to engage the first linkage 56 and securethe position of the end effector 54 in a vertical direction. The armclamp 64 can be rotated in an opposite direction to disengage the clamp64 and allow an end user to move the first linkage 56 and adjust theheight of the end effector 54 and pivot port.

The table mount base 24 may include a jaw section 66 that can clasp ontothe rail of an operating table (not shown). The jaw section 66 can besecured to the table rail by a table clamp 68.

The second linkage 58 may be coupled to the first linkage 56 by a firstball joint 70. Likewise, the end effector 54 may be coupled to the thirdlinkage 60 by a second ball joint 72. The third linkage 60 may becoupled to the second linkage 20 by a pivot joint 74. The ball joints 70and 72, and pivot joint 74 provide the support arm six degrees offreedom. The position of the arm 50 and end effector 54 can be securedand locked in place by rotating a locking knob 76. The locking knob 76clamps the pivot joint 74 to prevent relative movement between the third60 and second 58 linkages. Rotation of the locking knob 76 also movescorresponding wedges (not shown) into the ball joints 70 and 72 tosecure and lock the second linkage 58 and the end effector 54,respectively. The arm 50 and table mount 52 can be purchased from KARLSTORZ under part number 28172H. The end effector 54 may have a springbiased retractable jaw 78 that can capture the pivot port 12. Theretractable jaw 78 allows an operator to readily attach and detach thepivot port 12 to the support arm assembly 14. The joints 70, 72 and 74allow the operator to adjust the pivot port 12 location and theinstrument 16.

The following medical procedure can be performed with the pivot point 12of the present invention. A patient's chest cavity may be opened and thepivot port 12 may be attached to the support arm assembly 14 adjacent tothe open chest cavity. A surgical instrument 16 may then be insertedthrough the pivot port 12 and attached to the robotic arm 18. Therobotic arm 18 may then be actuated to move the instrument 16 andperform a procedure. The pivot port 12 allows the instrument to pivotabout the port 12. When the procedure is completed, the instrument 16may be decoupled from the robotic arm 18 and pulled out of the pivotport 12. The pivot port 12 may then be detached from the support armassembly 14.

While certain exemplary embodiments have been described and shown in theaccompanying drawings, it is to be understood that such embodiments aremerely illustrative of and not restrictive on the broad invention, andthat this invention not be limited to the specific constructions andarrangements shown and described, since various other modifications mayoccur to those ordinarily skilled in the art. For example, although anopen chest procedure is described, the pivot port can provide a pivotpoint for any type of medical procedure.

What is claimed is:
 1. A pivot port that can support a surgicalinstrument controlled by a robotic arm, comprising: a pivot arm; a ringhaving an inner annular ring lip; a first link configured as a singleconnecting piece having pivotal ends; an adapter that has an apertureand an outer annular flange, wherein the aperture is adapted to receivethe surgical instrument, and wherein the outer annular flange rests onthe inner annular ring lip of the ring so that the ring supports theadapter; and, first and second joints, wherein a proximal end of thefirst link is directly connected to the pivot arm by the first joint sothat the proximal end of the first link is constrained to only berotatable at the first joint about a first axis of rotation that isparallel with a longitudinal axis of the pivot arm and a distal end ofthe first link is directly connected to only one outer side of the ringby the second joint so that the ring and the adapter are rotatable atthe second joint about a second axis of rotation that is maintained by ashape of the first link to be approximately orthogonal to the first axisof rotation so as to allow the surgical instrument to pivot about saidaperture when the pivot arm is locked in place and the instrument isreceived in the aperture.
 2. The pivot port of claim 1, wherein thefirst axis of rotation is coincident with the longitudinal axis of thepivot arm.
 3. The pivot port of claim 1, wherein the second axis ofrotation is coincident with the diameter of the ring.
 4. The pivot portof claim 1, wherein the first link is freely rotatable at the firstjoint and the adapter is freely rotatable at the second joint while thesurgical instrument is being controlled by the robotic arm.
 5. The pivotport of claim 1, wherein the adapter is constrained to only be rotatableat the second joint about the second axis of rotation.
 6. The pivot portof claim 1, wherein the first and second axes of rotation intersectwithin the aperture of the adapter so that the intersection serves as apivot point for the surgical instrument.
 7. The pivot port of claim 1,wherein the proximal end of the first link is bent at an approximately45 degree angle relative to a middle segment of the first link and thedistal end of the first link is bent at an approximately 135 degreeangle relative to the middle segment of the first link.